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Organization
OSF LIFELINE AMBULANCE, LLC
Active
Organization
OSF LIFELINE AMBULANCE, LLC
Active
Parent organization
OSF HEALTHCARE SYSTEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
OSF HEALTHCARE SYSTEM
Authorized official
JAMES M MOORE (CEO)
(309) 655-2850
Entity
Organization
Contact information
Practice address
318 ROXBURY RD, ROCKFORD, IL 61107-5090
(815) 395-4695
(805) 395-4643
Mailing address
PO BOX 17115, ROCKFORD, IL 61110-7115
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
471203
BLUE CROSS
IL
Enumeration date
12/06/2006
Last updated
04/09/2014
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